Multimedia informed consent helps with peds
Multimedia informed consent helps with peds
Informed consent can be a challenge with any patient, but it is particularly difficult with pediatric cases. One option is a multimedia presentation that can help get the necessary information across to the patient and family members in a more engaging way than the standard discussion.
Nemours, a health care system based in Jacksonville, FL, developed the program through a collaborative agreement with Emmi Solutions, a multimedia communications company based in Chicago.
The EmmiKids program uses animated web-based, interactive modules to facilitate parental informed consent for pediatric surgical, as well as medical, procedures. The pediatric system is the latest version of the Emmi program already used for adult patients. Module topics include general anesthesia, tonsillectomy and adenoidectomy, bilateral myringotomy, interventional cardiac catheterizations, inguinal hernia repair, repair of undescended testicles, hypospadias repair, and upper endoscopy. The system costs $360 per bed per year.
At A.I. duPont Hospital for Children in Wilmington, DE, the EmmiKids program is being used for bilateral myringotomy tubes and tonsillectomy surgery. Within the next several months, they will use EmmiKids for selected procedures in general surgery and urology. Anesthesia modules also have been developed.
When a case is scheduled, a surgery scheduler double checks that the EmmiKids program has been discussed by asking the patient, says Barbara Price, administrative coordinator in the Department of Surgery. "If the physicians have not broached the subject of EMMI, the surgical schedulers will then explain the program and subsequently enroll them," Price says.
The traditional informed consent process is highly variable and dependent on individual practitioner preferences regarding timing, content, process, and the clinician obtaining the consent, says Linda Pilla, JD, MBA, chief risk officer for Nemours.
The doctor has to go over this information 35 times a day and is under stress, Clark says. "He's not likely to do it the same way each time, so the EmmiKids helps ensure that the right information is always provided," he says.
The need for a uniformly high-quality pre-procedure education is clear. The perception of incomplete or improper informed consent is an element in up to 35% of medical malpractice actions, Pilla says. "Our goal was to find a way to provide a better and more consistent informed consent process, which we hoped would lower our risk overall while improving patient satisfaction," she says.
The web-based consent process is a more consistent way of providing the necessary information about a procedure and acts as a sort of backstop for the physicians, says B.J. Clark, MD, vice president of physician practices for Nemours Delaware. It is not a substitute for a good face-to-face informed consent conversation, he says, but rather a supplement to make sure all important points are understood. "One of the driving principles of this effort was to provide a complete and uniform body of information for a family of a child undergoing a procedure," Clark says. "The family can review the program at their own pace, as many times as they wish, and with as many family members as they wish."
The EmmiKids system allows the family to review important information about an upcoming procedure between the time they're informed that the child needs treatment and the time of the procedure. That timing can help overcome the parents' sense of being overwhelmed with information when first told of the treatment plan, Clark says. "There is a real question about how much information gets through to parents when they are still shocked and scared by what you've just told them. With this, they can take the time to adjust and then go online and review the information when they're more in control," he says.
Parents can go back and review information to make sure they fully understand what they discussed with the doctor, says Neil Izenberg, MD, founder and chief executive of The Nemours Center for Children's Health Media, in Wilmington, DE. The Nemours Center creates online, print, and video information to educate families about children's health issues.
"It really comes down to the ethical responsibility of the organization to make sure the families really understand what is going on," he says. "It's just not enough to say the information and write down that you said it, so then you can say you've done your duty. The real goal is to make sure the parents understand fully, and that's where this system helps." (See details of EmmiKids system. See information about parent satisfaction with the product. More information about pricing and other specifics of the system is available at www.emmisolutions.com.)
Source
For more information on EmmiKids, contact:
• Barbara Price, Administrative Coordinator, Department of Surgery, A.I. duPont Hospital for Children 1600 Rockland Road, Wilmington, DE 19803. Phone: (302) 651-5981. E-mail: [email protected].
Informed consent can be a challenge with any patient, but it is particularly difficult with pediatric cases. One option is a multimedia presentation that can help get the necessary information across to the patient and family members in a more engaging way than the standard discussion.Subscribe Now for Access
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